If my "Quick Check" card is damaged, lost or stolen, I/we may be required to pay a
replacement fee of $10.00 (ten dollars).

By signing this application, I/we authorize a consumer credit report and verify the statements in this application. Furthermore, I/we agree to be bound by the terms and conditions of the debit card including any fees and charges and the electronic funds transfer brochure, copies of which will be mailed to the applicant(s) if a card is granted. Receipt of terms and conditions, and disclosure, and acceptance of such terms will be conclusively presumed by the use of the card. If this is a joint application, the undersigned shall be jointly and severally liable for any and all debit card transactions. BOTH parties must sign if a joint account is desired.